1. Acute liver failure with a massive upper GI bleed meeting the criteria of MIS-C.
- Author
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Mishra A, Gupta J, Alam A, and Verma SK
- Subjects
- Humans, Male, Immunoglobulins, Intravenous therapeutic use, Hematemesis etiology, Duodenal Ulcer complications, Duodenal Ulcer diagnosis, SARS-CoV-2, Child, Preschool, Systemic Inflammatory Response Syndrome diagnosis, Systemic Inflammatory Response Syndrome complications, COVID-19 complications, Liver Failure, Acute diagnosis, Liver Failure, Acute etiology, Liver Failure, Acute complications, Gastrointestinal Hemorrhage etiology, Gastrointestinal Hemorrhage diagnosis, Methylprednisolone therapeutic use, Methylprednisolone administration & dosage
- Abstract
Multisystem inflammatory syndrome in children (MIS-C) is a known complication of COVID-19. There is still limited knowledge about this condition. Here, we report the case of a previously healthy toddler boy, who presented with acute liver failure and duodenal lesions resulting in severe haematemesis and haemorrhagic shock, requiring intensive care unit care. The patient had persistent transaminitis, a deranged coagulation profile, inflammatory markers were elevated, and laboratory tests were negative for common infectious hepatitis aetiologies as well as COVID-19 Reverse transcription polymerase chain reaction. His COVID-19 antibody was reactive. Upper gastrointestinal endoscopy revealed a Forrest grade III duodenal ulcer. Looking into the constellation of symptoms and laboratory findings a confirmed diagnosis of acute viral hepatitis caused by MIS-C was made. Hence, he was given intravenous methylprednisolone along with intravenous immunoglobulins, after which he improved clinically and transaminitis resolved. The patient was discharged on clinical improvement and was doing fine on follow-up up to 6 months., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2024
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